Please for the love of GOD, Robin Wittenstein please listen.
I realize this is coming from an anonymous web blog, and I spent a good deal of my life in one of your boo-boo buses in the late 80’s-early 90’s and am now firmly ensconced in a position at UC Health, which for all its good things is in fact a shit show, to the nth degree and gives nothing but lip service to serving the needy, of this state and even less to those of Denver, unless you are unlucky enough to suffer trauma, then of course we want you, because for all of our blathering about trauma, let’s be realistic, it is either imported from other UCH facilities or is a burn.
Now, I have no idea what DHMC payor mix is between trauma and medicine, but if it is close to what I believe, around 25+% then ask your CFO or your COO if your institution could take a hit of that magnitude to the bottom line. I’m gonna bet no, would be the resounding answer.
I know you are “short timing” it and if you care about your institution, you should make sure your fight with all the institution’s might to keep DFD from doing ever more ALS medicine.
I am not a fan of the “slippery slope” argument, and this is exactly what will happen. Hell, has been happening for last few years. Denver Fire keeps asking to do more interventions on scene and thus far, from my sources and from what I can see, they have yet to be told “no,” with exception of IV’s, it seems. If this comes to pass, if your Paramedic Division has issues hiring now, wait until it is broadcast far and wide, which it will be by the IAFF, Denver Fire is providing ALS care on scene.
When that happens, there may be medics that are ok with it, and they can still do that and MAKE more money elsewhere. But that isn’t my point. My point is, it will eventually lead to DFD saying, “why are we waiting for transport? We should just be providing it.” Or, we will let DHPD (Denver Health Paramedic Division) continue to transport. Bad news for DHMC, round two. Reason being, paramedics in general don’t like taking orders, especially from fire department medics, who are only doing it because their bosses and union see the value in the jump in personnel and budgets.
Finally, if DFD gets the idea they can direct where the medics transport, guess which Level One trauma center will take the biggest hit? That revenue stream that is ~25%. Reason being, they will transport to closest level one and unless they are in a very small area in the core of Denver itself, that isn’t closer than their “house,” DHMC looses out in that calculus. And god forbid they actually get their own transport rigs, because then there isn’t even a debate about which closest facility will get the bus.
The reason for all this? Easy and trust me, the data has not got better nor reversed itself in the last 12 yrs since this blog post by an economist.
The money quote:
The decline of demand has created a problem for firefighters. What Fred McChesney wrote some 10 years ago is even more true today:
Taxpayers are unlikely to support budget increases for fire departments if they see firemen lolling about the firehouse. So cities have created new, highly visible jobs for their firemen. The Wall Street Journal reported recently, “In Los Angeles, Chicago and Miami, for example, 90% of the emergency calls to firehouses are to accompany ambulances to the scene of auto accidents and other medical emergencies. Elsewhere, to keep their employees busy, fire departments have expanded into neighborhood beautification, gang intervention, substitute-teaching and other downtime pursuits.” In the Illinois township where I live, the fire department drives its trucks to accompany all medical emergency vehicles, then directs traffic around the ambulance—a task which, however valuable, seemingly does not require a hook-and-ladder.
The triggering article by Tony Koveleski.
And please for all that is Holy when is DHMC gonna fight back and reveal to someone, anyone that DFD response times are and probably always have been at least as piss poor as DHPD?
Veritas!
Does Tony K ever Stop…
…being a feckless cunt of a reporter? I mean seriously. It only took him 6 six months to get around to response times.
And from my understanding from people still in that system, it is only a matter of time before it implodes, based on the lack of leadership from The Chief, and the lack of backbone from the Medical Director.
To expound. According to my sources the Chief has said he has no interest in longevity of his paramedics, and is fine with them leaving after a short stay. A shame actually. And again from other sources, in The Division leadership, with few exceptions are despised and the folks on the street feel no support from them and feel they are getting ticky tacked to death. And they aren’t trusted by the rank and file medics. Maybe the mindset will change in the “C” suite at Denver Health and they will finally start paying the medics a commensurate pay as those who do similar jobs in the surrounding areas. I mean after all, those other agencies may call themselves Fire Departments, but they are in fact EMS and FARDF (Fire Alarm Reset and Dumpster Fire) agencies.
Medical Direction, in talking to my friends and acquaintances they don’t know if the medical director can’t say “no,” or won’t say “no” when it comes to DFD continually asking to do more medical stuff prior to arrival of EMS. This is important, for as Tony K said, DFD has 50 medics already in their ranks, and I am sure would be all too glad to hire more in the future, or “merge” with The Division. It is only a matter of time before DFD will ask, vis vi their little puppet in the Deputy Mayors seat for this expansion, to increase.
As for a merger and those in The Division who think they will slide right into a DFD spot. Yep, right at the bottom. Just like honest to god smoke eating “real” IAFF members (not EMS IAFF affiliate members) did when DFD merged/took over Glendale, Sheridan and Englewood. That is the best case scenario. The worse case is you are some bastardized civilian EMS division of DFD and you’ll see what being a “red headed step child” really gets treated like. Just like those in San Fransisco in the mid 1990’s, when I left there.
Mark my words, the moment that the medics at The Division feel that they are no more than a transport agency, the death of The Division is a fait accompli. This will be bad for The Division but worse for Denver Health. Why you ask? Because, as Tony K has reported about Trauma returns to DHMC, a large portion of that will in fact dry up when DFD takes over transport decision making. Because they want resources back in service as soon as possible, and because the state encourages closest appropriate destination, without regard to level of care or rates of survival, DFD directed buses will in fact go elsewhere. That my friends will then mark at a minimum the demise if not outright death of DG. As Trauma is a large driver of revenue as that is why my place, UCHealth obtained a level one designation.
Personally I put the over:under line of demarcation at 5 yrs. I hope I am wrong for both those in the Division and more so for the people of Denver who rely upon DH for care, since lets be honest UCHealth only does enough to say they do it.
https://news.yahoo.com/firefighters-sound-alarm-understaffing-delays-052519209.html
Veritas!!!
Dangerous, reporting
Anthony, Anthony, Anthony Koveleski. Oh how I have missed you, like a boil on my ass, i have missed you. But just like a boil, you return and serve no purpose.
Let’s go to the video. First and foremost, your disguises are not any better in the last 13 years. I don’t know who the fuck you get to do them, but you should fire them.
Cast of Characters: TK-Tony K, Dr. McV, Glasses and Hat/GH, Ponytail. Unseen Characters: Robbie Dumond, and CDPHE.
Introduction GH and Ponytail inform us that they have driven by Level one trauma centers to get to Denver Health and the patient had a poor outcome and They are not in it for what is right for the patient. Really, these two really believe that any other level one has better outcomes? You know what would be a way to solve this? How about letting the ACS (the verification folks) no longer de-identify institutions with whom data is compared when looking at outcomes? I wonder why they did that in the first place?
Tony, states to Dr. McV that he out profit above pt care. Point of order douche-canoe, Denver Health is not a “for profit” institution. Simple google would fix that issue for you.
PT-when asked why no longer a Denver Health Paramedic-“it was destroying me as a person.” Seriously?
GH is asked if he was ever asked about taking a critical patient to a different institution, yes he was. why is this shocking, you work/worked at a place of higher learning, where being asked questions is part and parcel of getting better at the craft?
Ponytail asked if he got in trouble for not taking patients to Denver Health, he says he was, and I will call Bullshit. Being asked about ones critical decision making is not “getting in trouble.” In my day there and in talking with people still there, no medic has ever been disciplined for medical decision making, period. Have they been asked about it, hell yes, as noted, DH is part of the University Medical education system, filled with residents. Part of learning is being asked about the critical decisions made. and that does not then ≠ discipline.
GH-“Two kinds of paramedics who work at Denver Health, those who take all code 10 trauma to Denver health and those who use to work there” and if you don’t then “they” will find a way to get you to leave.
The crux of the story, a shooting victim, that was at a free standing ED, owned by the UC health system. A new level one trauma center. Time is important the ED doc informs us. Yes, it is important, but not as important in getting the right patient, to the right place. The golden hour was drawn up on a napkin, and while there are some data to suggest that time is a criteria for better outcomes, it is one of those criteria, not THE criteria. This is the same argument, at other end of the call, that Fire Departments make in effort to take over EMS systems, since they no longer fight fires.
GH claims there is some politics involved in this and he is right, and they it is coming from the University. They are a level one that must have certain numbers of critical patients admitted in order to maintain that status. They need those critical patients in order to maintain their verification. The institution of UC health is as predatory as HCA is in every regard.
The Denver channel closes with rehashing Tony K stories about a person with a saddle embolism, who if anyone knows a thing about them, knows it an ambulance had been parked on jetway, on the arrival, he’d still be just as dead. You can find my responses to both on this Blog.
Lastly, it is my understanding that CDPHE is investigating the medic who made the decision on the freestanding UC health GSW case. To the medics at The Division, understand which entity is responsible for this. It is UC Health, pure and simple. They are the ones who propagated this story and the medics are merely the pawns in that action.
And, having said that, you should judge your admin, the hospital and Medical Director on how they defend this individual.
To the same individuals and groups referenced above, you should and will be judged by your response and defense of this medic, as you should be and it should be as public and as loud and proud as it can be, for no other reason than 200 plus sets of eyes are upon you and will judge you. The repercussions will have impact now and in the future.
Continuing about the Sate/CDPHE
Go here and scroll to section 7- “Disciplinary Sanctions” and other than the catch all “…but not limited to” tell me which of these can be used to discipline the medic in question.
Or go here and scroll down to section 101-3 bypass for Trauma Patients
Whether bypass is necessary must initially be determined by the criteria in the
algorithms. However, deviations from the algorithms may occur due to the patient’s
emergency conditions, excessive transport time to the nearest trauma center, specific
medical direction, or if it is determined that air transport is the most appropriate option for
the patient.
In closing, yes I work for the UCHealth system, and I support them, generally. What I despise is them making this about and the medic potentially paying the price for a marginally medical, and largely political maneuver. I also see/know that DH has a mission. That mission is made marginally more difficult, by the manner in which the state has gone about the Trauma System management.
Veritas-OUT!
Just Something to chew on, whilst I prepare for Tony, AGAIN!!
Email today from a tangential follower
Got an email today that informed me about three sites on instagram I should let you all know about, but I suspect most already do. The first one, I already threw up a link to, the DHWUnion site.
The other site is the Anti-union site. This one is not terrible, but clearly also not as well done as the last one.
Lastly there is the Denver Emergency Memes page. This is run by a group calling themselves the Denver Regional Emergency Meme Advisory Council. This is some funny shit. This is the site that a friend wrote the email about, as he had been accused of being the proprietor.
As much as I have been pointing out flaws of those in charge of the Division, McVaney and Bryskiewicz, the latter, who I constantly and consistently hear is disengaged and it seems from the meme page, that view is shared by most, there is a lot of truth about the posts in the anti union page.
Veritas-Out!
Tell me you are economically ignorant, without saying so…
oh for the love…
Seriously, the president of the city council is going to let a news story from Tony K. direct health care decisions, instead of you know DATA?
First off the state has that corner of stupid staked out and has laid claim to it with its interference in the use of Ketamine.
Second, I can assure you, as I work at the UC Aurora and if I get into trauma trouble in the parking lot, I want to be taken to Denver Health. Good lord woman, lives, black and brown those you claim to be of interest in would die in greater frequency if they take them to my hospital.
Ketamine
I wish no ill will on anyone, and there will be a death in police custody that would have been preventable, had Ketamine been available. When it happens and I find out about it, gonna send the news to the fucking idiots in the Colorado Legislature who wrote the bill, passed the bill and the idiot who signed it, as the blood of that person will be on their hands
Questions and…
Why the need for disguises? If indeed they are whistleblowers, aren’t they covered by that law? If they aren’t current employees, then why need for same? If they are ex-employees, who happen to work for the UCHealth system, shouldn’t that be shared with the audience in the name of full disclosure? If an ex-employee from DH, that was terminated for reasons other than this topic, shouldn’t that be shared in the name of full disclosure?
Notice how they only speak of “bypassing” level one trauma centers? unless I am mistaken, UCHealth is the only one in which that could be the issue, as St. Anthony, no longer a “mistake by the lake,” has vacated the city, and Swedish, is in Englewood. That being the case, when do we think Anthony K will get around to asking The UCHealth about their political/operational reasons behind this issue?
Veritas-OUT!!!
Dr. Moore
He did this and then according to my sources, this “triggered” some folks at DenverHealth, of course. Which prompted a response, because of course everything has to have a response. Never mind that he is a staunch spokesperson for the banning of “assault weapons.” Never mind that he has literally saved untold numbers of victims of violence, the majority of which are predominantly minorities. Never mind that his teaching/research has save countless others. No, a milquetoast statement on the local news and I can only imagine what some of the folks at DG wanted, no less than his head on a platter for deigning to speak out of place.
Dear colleagues,
I have received a number of concerns about a recent TV news story that featured Dr. Ernest Moore expressing his personal opinions on current affairs. The views he expressed are his own, and do not represent those of Denver Health. As a private individual exercising his right to free speech, Dr. Moore did not need to seek permission before speaking to the media, and Denver Health was not aware of the interview until it was published. The interview was not conducted at Denver Health. Denver Health was not contacted by the TV station, and the video used in the report was not provided by Dr. Moore. It is in the public domain, as such we did not provide permission nor does the TV station need permission for its usage.
I want to thank those of you who shared your point of view with leadership or with me directly. Your comments are very important and your voices were heard.
Denver Health is deeply committed to full and equal access to health care for all members of our community. As part of our mission, we will continue to work for social justice to address structural racism and inequity in our society, in the medical profession and at Denver Health.
Thank you for all that you do.
Robin D. Wittenstein, EdD, FACHE
Chief Executive Officer
Son of Right Patch 